Less invasive procedures can provide desirable medical results with reduced recovery time and reduced risk to the patient. Thus, many surgical procedures are performed using endoscopes or the like in percutaneous formats. A large number of less invasive procedures within the cardiovascular system are now commonly performed, such as angiograms, angioplasty procedures and stent delivery procedures.
Endovascular procedures on or in the vicinity of the heart can create a risk of emboli generation in the aorta near the heart. Other procedures on the heart may also generate emboli along the ascending aorta. Emboli in the ascending aorta can enter the carotid arteries along the aortic arch, and emboli in the coronary arteries can travel to the brain and cause a stroke. Heart valve prostheses have been successfully used to replace damaged natural heart valves that no longer perform their functions in a satisfactory way. Commercial heart valve prostheses include both mechanical valves with rigid occluders and tissue-based prostheses with flexible leaflets. These valves have been implanted surgically through the chest with the patient on cardiopulmonary bypass. Prosthetic heart valves have been developed for percutaneous or endovascular delivery, such as the Sapien™ aortic heart valve prosthesis from Edwards Lifesciences. While endovascular procedures are significantly less invasive to the patient than procedures through the chest wall, these procedures can create risk from emboli within the aortic root that can travel to the brain and cause strokes. Ghanem et al. for example discussed embolization during transcatheter aortic-valve implantation procedure in an articled in Journal of American College of Cardiology Vol. 55, No. 14, 2010, pg. 1427-1432 entitled “Risk and Fate of Cerebral Embolism After Transfemoral Aortic Valve Implantation,” incorporated herein by reference.